| 摘要: |
| 目的:系统评价我国静脉用药调配中心(PIVAS)质量管理现状,探讨不同PIVAS 质量管理工具的使用情况及管理效果,
为我国PIVAS 质量管理的发展提供参考。方法:计算机检索PubMed、Web of Science、EMBase、the Cochrane Library、中国生物医
学文献数据库(SinoMed)、中国知网、万方、维普数据库等,检索时限均为建库至2024 年6 月,纳入评价我国PIVAS 质量管理的
研究,提取质量管理的管理工具、指标、成效等信息,进行描述性分析。结果:共纳入267 篇文献,包括前后对照研究238 篇,随
机对照试验29 篇。PIVAS 应用质量管理工具有22 种,主要包括PDCA 循环、品管圈(QCC)、持续质量改进(CQI)、目视管理、六
西格玛管理、精益管理、循证护理、6S 管理、前馈控制、全面质量管理、目标管理等。各质量管理工具主要应用于审方、摆药、配
置、复核、配送、洁净环境监测、手卫生监测、成品输液质量监测、药物储存及盘点、工作人员评价、满意度、患者评价、退药、药品
损耗、服务质量等。绝大多数质量管理工具能有效改善全部设定指标,且它们在不同环节被应用的频率存在差别。结论:我国
PIVAS 质量管理工具应用呈现多样化特征且成效显著,但仍存在研究同质化、评价指标不统一等问题。建议未来开展更高质量
研究,例如应用同一质量管理工具或不同质量管理工具对PIVAS 质量管理全环节的作用研究,以及不同地区之间、不同类型医
疗机构之间的对比研究,从而进一步促进我国PIVAS 质量管理工具应用的规范化。 |
| 关键词: 静脉用药集中调配中心 质量管理 循证评价 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.10.005 |
|
| 基金项目:四川省自然科学基金项目,编号2025ZNSFSC0736 |
|
| Evidence-Based Evaluation of Current Status of Quality Management Tools in Pharmacy IntravenousAdmixture Services in China |
| Zhao Zhipeng, Yang Yaya, Yang Chunsong |
| ((West China Second Hospital, Sichuan University, Key Laboratory of Birth Defects
and Related Diseases of Women and Children, Ministry of Education, Chengdu 610041, China)) |
| Abstract: |
| Objective: To systematically review current status of quality management tools in Pharmacy Intravenous Admixture Services
(PIVAS) in China, and to provide basis for the development of quality management in PIVAS in China. Methods: PubMed, Web of
Science, EMBase, the Cochrane Library, SinoMed, CNKI, Wanfang, and VIP databases were retrieved to collect studies related to
PIVAS quality management in China from the database establishment to Jun. 2024. Data on management tools, performance indicators,
and outcomes were extracted and analyzed descriptively. Results: A total of 267 articles were enrolled, including 238 prospective and
retrospective studies and 29 randomized controlled trials. Twenty-two distinct quality management tools were documented, including
PDCA cycles, quality control circles ( QCC), continuous quality improvement ( CQI), visual management, six Sigma, lean
management, evidence-based nursing, 6S management, feedforward control, total quality management (TQM), and management by
objectives (MBO). These tools were applied across multiple PIVAS workflow stages: prescription review, dispensing, admixture
preparation, final product review, distribution, clean environment monitoring, hand hygiene compliance, finished infusion quality
control, drug storage/ inventory management, staff performance assessment, satisfaction surveys (staff/ patient), patient feedback, drug
return processing, wastage management, and service quality. While demonstrating effectiveness in addressing issues at various stages,
the frequency of tool application varied significantly. Conclusion: The application of diverse quality management tools across PIVAS workflows in China demonstrates varying degrees of effectiveness. However, limitations persist, including a narrow research scope and
substantial heterogeneity in evaluation metrics. Future research should prioritize higher-quality study designs to strengthen the practical
application of these tools, including rigorous evaluation of impact of identical or different tools across all PIVAS stages and comparative
studies across diverse regions and types of healthcare institutions to further standardize quality management practices in PIVAS in China. |
| Key words: Pharmacy Intravenous Admixture Services quality management evidence-based evaluation |
